Respiratory Distress Syndrome

Respiratory distress syndrome (RDS) is a disorder of lung function frequently affecting premature infants. Infants born at less than thirty-two weeks gestation are at the highest risk. RDS is caused by the inability of immature lungs to produce sufficient amounts of the chemical surfactant. Without surfactant, the small air sacks of the lungs collapse, resulting in poor exchange of oxygen and respiratory distress. RDS may be severe enough to cause respiratory failure and the need for support with a ventilator. Generally, RDS lasts three to five days; infants with mild cases recover quickly. Sicker infants may require long-term respiratory support and can develop chronic lung disease. RDS may be prevented and treated with the administration of surfactant into the lungs of at-risk or affected newborns. Preventing premature birth and treating pregnant women with steroid therapy prior to a premature birth decreases the chances of immature lungs and RDS. However, RDS remains a leading cause of death for premature infants.


Linden, Dana, Emma Paroli, and Mia Doron. Preemies: The Essential Guide for Parents of Premature Babies. New York: Pocket Books, 2000.

Spafford, P. S. ''Use of Natural Surfactants to Prevent and Treat Respiratory Distress Syndrome.'' Seminars in Perinatology 17, no. 4 (1993):285-294. Taeusch, H William, and Roberta Ballard. Avery's Diseases of the Newborn. Philadelphia: W. B. Saunders, 1998.

Diane D. Marshall

Retention, sometimes called flunking, is the practice of having a child repeat a grade in school to help the child acquire the academic and social skills needed for success in later grades. Most research, however, has found that simply repeating the same grade is not very effective. Although children who are retained often perform better during their second year in the same grade, their gains usually shrink or disappear in subsequent years. Moreover, children who are retained are more likely to develop a bad attitude toward school and are more likely to drop out of school than nonretained children with similar levels of poor achievement.

Since the mid-1990s, public policies against social promotion (i.e., advancing children to the next grade despite poor achievement, to keep them with children of the same age) have spurred the development of programs to help struggling children avoid retention. The same programs, such as extra tutoring, summer school, and increased use of classroom aides, could also help retained children gain more from their experience.



Karweit, Nancy L. ''Grade Retention: Prevalence, Timing, and Effects.'' In the Johns Hopkins University CRESPAR [web site]. Baltimore, Maryland, 1998. Available from http://; INTERNET.

Riley, Richard W., Marshall S. Smith, and Terry K. Peterson. ''Taking Responsibility for Ending Social Promotion: A Guide for Educators and State and Local Leaders.'' In the U.S. Department of Education [web site]. Washington, DC, 1999. Available from; INTERNET.

Shepard, Lorrie A., and Mary L. Smith. Flunking Grades: Research and Policies on Retention. London: Falmer Press, 1989.

Pamela P. Hufnagel

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